Clinical Cases / Foundation

Struggling in restaurants Foundation

Vignette

A 72-year-old reports increasing difficulty following conversation, especially in noisy restaurants, over several years. Hearing is described as equal in the two ears. Otoscopy is normal.

-100204060801001202505001k2k4k8kFrequency (Hz)Hearing level (dB HL)
  • O Right ear, air
  • X Left ear, air
  • < Right ear, bone
  • > Left ear, bone

Signature: Symmetrical, gently sloping high-frequency sensorineural loss; air and bone conduction track together.

Figure 1. The audiogram. Bone conduction tracks air conduction. No air–bone gap.

Question

What is the most likely diagnosis?

References

  1. [2] Clark JG (1981). Uses and abuses of hearing loss classification.